The article presents an overview of the main modern methods of treatment of demodecosis, the main antiparasitic drugs and alternative treatment regimens, their advantages and disadvantages. The aim of the study was to compare combined method of demodecosis treatment with external treatment with 7% metronidazole. 64 patients with acne and rosacea complicated demodecosis, which were divided into two groups depends on a method of treatment (250 mg of metronidazole per os 2 times a day, externally 1% metronidazole once a day for 20 days or 7% metronidazole externally, 20 days, respectively). The effectiveness of therapy in both groups was the same. It was a significant decrease in the number of morphological elements, reduction of subjective complaints of patients after the treatment. This study represents a lack of superiority in systemic therapy of demodecosis, compared to external therapy.